Third and Fourth Periodic Report on CRC - Unicef

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<strong>Third</strong> <strong>and</strong> <strong>Fourth</strong> <strong>Periodic</strong> <strong>Report</strong> aimed at parents also have a positive impact on children by increasing the family income <strong>and</strong> improving the family’s overall st<strong>and</strong>ard of living. Various initiatives have also been taken by the Government to improve the housing situation of the poor, for example, through schemes to rehabilitate slum dwellers, <strong>and</strong> provide housing for l<strong>and</strong>less <strong>and</strong> low-income families, <strong>and</strong> most importantly micro credit programmes. Use of sanitary latrine is increasing (close to 80 percent population), 97 percent households have access to improved water sources, the overall safe water coverage is at 75 percent because of naturally occurring arsenic contamination of ground water. Use of telephone, computer <strong>and</strong> Internet is increasing at a faster rate. Of the total households, 44 percent have electricity. GNP per head is now in the country at US$ 480 <strong>and</strong> overall HDI rating is increasing gradually. 6.7 Nutrition <strong>and</strong> breastfeeding 6.7.1 Nutrition Millions of children in Bangladesh suffer from malnutrition, increasing the possibility of childhood illness <strong>and</strong> mortality. It is a direct result of the high prevalence of low birth weight (LBW), inadequate dietary intake <strong>and</strong> diseases, <strong>and</strong> an indirect result of household food insecurity, inadequate maternal <strong>and</strong> childcare <strong>and</strong> poor health services. Other causes of malnutrition include inadequate breastfeeding <strong>and</strong> infant feeding practices <strong>and</strong> infectious diseases, including diarrhoea. In all, roughly half the country’s rural households can be considered food insecure. According to the Household Income <strong>and</strong> Expenditure Surveys roughly poorest 20 percent in 2000 <strong>and</strong> 19.5 percent in 2005 consume less than 1805 kilo calories, against the minimum caloric requirement set in Bangladesh at 2112 per day. In 2005, total 40.4 percent population consumed less than 2122 kilo calorie, 39.5 percent in rural <strong>and</strong> 43.2 percent in urban areas. The country has been quite successful in achieving the target in terms of grain production (paddy <strong>and</strong> wheat), which reached around 27 million Metric Ton (MT). Even with the near self-sufficiency of food production, food security could not be ensured. There are regional <strong>and</strong> seasonal disparities in food production <strong>and</strong> availability. While Dhaka, Khulna <strong>and</strong> Chittagong are considered to be food deficit areas, in contrast Rajshahi by <strong>and</strong> large has food surplus. Again, Bangladesh experience two major periods of food shortage, February to March <strong>and</strong> September to October. Natural calamities, which is quite frequent in the country cause regional <strong>and</strong> time-specific food insecurity. Cereal-biased dietary habit is also considered another important reason for food insecurity. A. Maternal malnutrition The prevalence of malnutrition LBW is high because adolescent girls <strong>and</strong> women who do not consume adequate nutritious food during pregnancy. Malnutrition in non-pregnant rural women declined from 54 percent in 1996-7 to 49 percent in 1999-2000, but is still considered high with 35.2 percent in 2005 (BBS). The national average in 2005 was 32.2 percent. Severe anaemia during pregnancy increases the risk of maternal death <strong>and</strong> or having underweight children. The most common cause is iron deficiency. Other important causes include deficiencies of folic acid <strong>and</strong> vitamin A, parasitic infections such as hookworms <strong>and</strong> malaria. B. Child malnutrition Children’s malnutrition is reflected on their overall health status particularly in terms of LBW, low childhood growth (stunting), vitamin A deficiency, iodine deficiency disorders <strong>and</strong> anaemia. However, child’s malnutrition mainly stems from mother’s poor health <strong>and</strong> nutrition. Bangladesh has made significant progress in child malnutrition in the recent years, as discussed in the following sections. 62
Convention on the Rights of the Child Low Birth Weight <strong>and</strong> Growth: MICS 2006 indicates that as low as 26.7 percent of infants are estimated to weigh less than 2.5 kg. There are some variations between income group <strong>and</strong> mother’s education, as MICS suggests, but not between rural <strong>and</strong> urban areas. Like other developing countries, Bangladesh is not only facing the major challenge of improving child nutrition, but also has been experiencing the problem in weighing children. MICS 2006 shows that only 15.5 percent babies are weighed at birth. However, the overall situation is improving. The percentage of children aged 6-59 months with stunting (low height) decreased from 51 percent in 1995 to 48 percent in 2000 <strong>and</strong> further to 46.2 percent in 2005; underweight decreased from 57.2 percent in 1995 to 51 percent in 2000 <strong>and</strong> 39.7 percent in 2005; <strong>and</strong> wasting (too thin) decreased from 17 percent in 1995 to 12 percent in 2000 <strong>and</strong> increased to12.7 percent in 2005 (BBS & UNICEF, 1992, 2000, 2005). Table 6.4: Nutritional Status of Children in Bangladesh, 1989-2004 (in percent) Year Residence Height-for-age Weight-for-height Weight-for-age (Stunting) (Wasting) (Under Weight) Boys Girls Both Boys Girls Both Boys Girls Both 1989-90 National 65.6 65.9 65.4 15.3 13.8 14.4 64.8 67.8 65.8 1995-96 National 51.6 51.2 51.4 15.9 17.3 17.0 56.8 58.1 57.4 Urban 42.0 43.9 42.9 15.6 10.6 13.3 45.4 47.2 46.3 Rural 53.2 52.4 52.8 16.0 18.5 17.2 58.8 59.9 59.3 2000 National 48.4 49.1 48.0 12.0 11.4 12.0 51.3 50.9 51.0 Urban 38.9 37.9 38.5 12.0 9.4 10.9 44.7 39.8 38.5 Rural 50.1 51.3 50.2 12.0 11.8 12.2 52.5 53.0 50.1 2005 National 47.1 45.3 46.2 12.7 12.7 12.7 40.3 39.0 39.7 Urban 38.0 33.7 35.9 10.8 10.8 10.8 30.1 29.7 29.9 Rural 49.4 48.2 48.8 13.0 13.2 13.1 43.0 41.3 42.2 Vitamin A deficiency: Bangladesh has reduced vitamin A deficiency over the years. Vitamin-A supplementation of children aged 12-59 months rose from 41 percent in 1993 to 85 percent in 1995, <strong>and</strong> has been sustained at more than 85 percent throughout the last decade. In 2005, the coverage was 93 percent nationwide, 92 percent in rural areas <strong>and</strong> 94 percent in urban (CNS 2005). Vitamin A supplementation twice a year, made it possible to maintain the prevalence of night blindness sustained well below the 1 percent threshold that signals a public health problem. The supplementation programme coverage increased mainly because of linking the distribution of Vitamin A capsules with the National Immunization Days (NID). In Bangladesh within the six months as per MICS 2006, some 85 percent children aged 6-59 moths received a high dose vitamin A supplement. Iodine deficiency: Bangladesh is affected by iodine deficiency disorders (IDD). Due to universal salt iodization programme, the goitre prevalence decreased from 47 percent in 1993 to 18 percent in 1999, <strong>and</strong> biological iodine deficiency decreased from 69 percent in 1993 to 43 percent in 1999 (National IDD Surveys, 1993 <strong>and</strong> 1999). Household consumption of iodized salt has increased from 14 percent in 1995 to 84 percent in 2006 (MICS 2006). Use of Iodized Salt was lowest in Chittagong Division (77.7 percent) <strong>and</strong> highest in Khulna Division (93.6 percent) <strong>and</strong> there is 10 percent variation between rural <strong>and</strong> urban areas. However, the difference between richest <strong>and</strong> poorest households in terms of consumption of iodized salt is 20 percent. 63
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